What Makes A Shooter Snap?

This is TELL ME MORE, from NPR News. I'm Michel Martin. Coming up, the NCAA has leveled severe penalties against Penn State for failing to stop former assistant football coach and convicted sexual predator Jerry Sandusky. We'll have the latest on that story in a few minutes.

But first, we want to take a look at the aftermath of the mass shooting in Aurora, Colorado. James Holmes, a 24-year-old former graduate student is in custody for the deadly shooting at a movie theater early Friday morning. Twelve people were killed and more than 50 others were injured.

It's left the town and the country looking for answers including what could possibly lead a person to commit such an act of violence? Here's some of what Colorado governor John Hickenlooper said yesterday about James Holmes, the alleged gunman. Governor Hickenlooper was speaking on "Meet the Press."

(SOUNDBITE OF TV SHOW, "MEET THE PRESS")

GOVERNOR JOHN HICKENLOOPER: He was diabolical, demonic in this twisted sense that he just - I mean, I think of him almost as a terrorist, right? He wanted to take away not just the people in that theater but from our country our ability to enjoy life, to go to a movie theater, which is, for most of us, is a refuge where we can get away from the rest of some of the pressures of life.

MARTIN: We want to try to begin to understand whatever we can understand at this early stage about what might motivate somebody to do something like this, so we've called upon two people who have thought a great deal about this from their respective vantage points.

Joining us, Dr. Carl Bell. He's the president and CEO of the Community Health Council in Chicago, Illinois. He's been a practicing psychiatrist for more than 30 years, but he's also an internationally recognized lecturer and author who's thought a lot about and given lots of presentations on mental wellness, violence prevention and the traumatic stress caused by violence.

Also with us is Dave Cullen. He is the author of "Columbine," a book about the 1999 mass killing at Columbine High School in Littleton, Colorado. Cullen was one of the first journalists to cover that story. He's also written an opinion piece for the New York Times this weekend about Friday's shooting titled "Don't Jump to Conclusions" about the killer.

And they're both with us now. Welcome to you both. Thank you for joining us.

CARL BELL: Thank you.

DAVE CULLEN: Thanks for having me, Michel.

MARTIN: And Dr. Bell, I'm going to start with you because as we've mentioned, you've talked a lot. You've practiced psychiatry for many, many years. And, you know, we do understand that you have not evaluated this young man.

BELL: Right.

MARTIN: But just based on what we know now, what do you see?

BELL: Well, you've got a person who's under 26, which means that in child development and young adult development, most people under 26 are all gasoline, no brakes and no steering wheel. Which is a common, ordinary way of talking about neuro development. So that's one issue.

The other issue is that you've got a person who's in an academic institution, and our academic institutions are very poorly prepared to deal with people with serious mental illness because we've been doing a better job of treating people. So they're able to get to college. But then the counseling and educational aspects of higher education are used to counseling people who are not seriously mentally ill. So that could also be a factor here.

MARTIN: And, you know, I think that struck me too because many people will remember the Virginia Tech shooting, that awful shooting at Virginia Tech, where a student killed, you know, dozens of his classmates and professor.

BELL: Right.

MARTIN: But one of the things that struck me there was that he had been sending up all kinds of signals and lots of people...

BELL: Yes.

MARTIN: ...within the university had been trying to help him.

BELL: Right.

MARTIN: Or get help for him.

BELL: Right.

MARTIN: And for some reason weren't able to break through. And I just wanted to ask Dr. Bell briefly before I turn to Dave Cullen, why is that?

BELL: Well, again, you know, you've got people in higher ed who are used to sort of normal teenagers, young adults, who are not seriously, persistently, chronically mentally ill. And so they're not really prepared - the infrastructure to prescribe medications which would help somebody with that problem is few and far in between in the higher academic institution because they're used to the normal people with issues, as opposed to mentally ill people with psychiatric disorders.

MARTIN: Dave Cullen, in your piece, "Don't Jump to Conclusions" about the killer, one of the things that you said very strongly in your piece is that, you know, we have a tendency to jump to certain misconceptions about the people who participate in these kinds of actions. What are some of those misconceptions that you see based on your experience with Columbine? And do you see that same thing playing out here?

CULLEN: Sure. Well, first of all, the public does have this sort of imaginary profile of these killers.

BELL: Mm-hmm.

CULLEN: That they're loners, outcasts, or someone sort of on the margins of society who doesn't fit in, introverts. And then a lot of people also assume either sort of one of two things. A lot of people assume the person must be crazy or insane or however we want to define that. And also the term psychopath is often bandied about.

BELL: Yep.

CULLEN: Or what Governor Hickenlooper said and, you know, I don't want to knock him much because I think he's been fantastic through all this. I think just yesterday he started to stray a little bit into - I was very queasy about his comments of saying that, you know, this killer was diabolical and demonic.

You know, we don't know that yet. And particularly if this person was somebody who was suffering from severe mental illness, was schizophrenic - I'm just saying that that's just a possibility, not a probability.

BELL: Mm-hmm.

CULLEN: But if he was and didn't know what he was doing then he definitely wasn't demonic. And even diabolical, we don't really know yet. There are different types. And there are sort of four main types of killers, which I can tick off and we can talk if you want.

But there's angry-depressives, the deeply mentally ill who are sort of out of touch with reality, whether that's schizophrenia or whatever. There's psychopaths in the clinical sense who have no empathy and know what they're doing and don't care. And then there's terrorists. And the largest group by far of the mass shooters are the depressives who are completely different than I think most people imagine a diabolical killer. They're not diabolical; they're deeply troubled and they're sort of at war at themselves and they're lashing out.

MARTIN: Hmm. Well, let me ask Dr. Bell about that and I'll just point out that Dave Cullen, in your piece you said that one of the shooters in Columbine, Eric Harris, fit the stereotype that many people have of mass killers. He had been keeping a journal. It was full of threats and hatred and anger. But Dylan Klebold, the other shooter, had talked about suicide consistently.

Really, he was depressed and for some reason that self-hatred reflected kind of reflected outward. Dr. Bell, I wanted to ask you to pick up the thread there. Talk about - particularly given the age group of the person we're talking about here.

BELL: That's absolutely correct. Then there are other categories. So you get these messianic people who kind of feel like they're on a mission from God, and they might be more manic as opposed to schizophrenic. But Cullen is absolutely correct because a lot of times what is played out are that these are suicides that are preceded by mass murders.

CULLEN: Mm-hmm.

BELL: And so there's a sense a lot of times suicidal people want to get even or they want recognition or they want people to understand how much they've suffered. And what better way of playing that out than killing a whole bunch of people before you kill yourself?

Now in this instance, we at least know that he did not do that, which is an interesting thing, especially around the notion of copycat suicides, which is a well-established scientific reality, that the more attention you give to these people who are the depressed types, the more you see copycat or contagion effects. So it's a very complex issue.

MARTIN: It is a complex issue and unfortunately we don't even begin to have the time to dig into it here, but Dr. Bell, I did want to ask you because you have thought about this and taught about this and researched this. You have some ideas about what it is that people can do, and what you think particularly people who are engaged with people this age could be doing better.

BELL: Oh, yeah. The research is extraordinarily clear. The more that we have social fabric around these folk - around everybody, actually - the more protective it is of them. The more we monitor folk who do things like this. Had this person been monitored, somebody would've said, hey, what are you doing with all that gasoline?

The more we can have people who are a bit quirky or strange or different be brought into the society and be tolerant and connected, so that the more tolerance we have of diversity is helpful. The more that we can have people express themselves verbally and have an output, a way to tell people, look, I'm feeling badly, the less people have to act out.

And the more they're connected and have a sense of safety, I think we prevent a lot of people from acting out on their deep, deep, dark emotions.

MARTIN: Dave Cullen, do you feel comfortable hazarding some thoughts about this, as well, based on your reporting about Columbine? I mean...

CULLEN: Sure.

MARTIN: ...you don't want to tip into, you know, stereotyping and profiling people based on the kinds of music that they listen to or what they wear, but what about real reporting? What would you suggest that institutions could be doing differently?

CULLEN: Well, I think that there's one huge thing we can do, which is depression. Because regardless of what drove this person in Aurora - you know, we will find that out eventually - but to some degree, that's a little irrelevant, because we've already suffered that tragedy. We can't undo that one. It's too late.

What we can do is, you know, add him to the group. But what we want to do is look at all the mass killings and what are the most common causes there, what - you know, how we can prevent them. And the biggest thing that leaps out is that the majority are depressives.

BELL: Right.

CULLEN: And we're doing a really poor job in this country at identifying depression, especially during the teen years. And there have been a couple different reports by - the name is escaping me. I think it's the American Pediatric Association or some - a couple of different blue ribbon panels, forgive me - have made very similar recommendations that all adolescents should be screened. And it's very, very easy to do. In just a couple of minutes, the family doctor can do it, or counselors at school - but to identify these kids who are depressed. And they're easy to identify.

Kids will usually tell almost all adults that they are having a problem because they want to get help, except with one exception. They usually will hide it from their parents because they feel embarrassed or ashamed. They sort of want to protect their parents, and so they're not telling their parents. They're telling their parents they are OK, or they're clamming up and giving, you know, two word answers, like a teenager will.

But if you screen them by having another adult, in most cases, they will tell that adult and they can get help and, you know, depression is very treatable. This doesn't have to go on.

MARTIN: Dr. Bell, a final thought from you. We only have about 30 seconds. Do you agree with that, that intervening, particularly on depression, would go a very long way?

BELL: Yes. It's actually - the Institute of Medicine reducing suicide report and a recent prevention report. Also, that both Republicans and Democrats have suggested screening early for these psychiatric disorders, because the earlier you treat them, the less problems you have later in life.

MARTIN: Dr. Carl Bell is the president and CEO of the Community Mental Health Council in Chicago, Illinois. He was kind enough to join us from WBEZ. Dave Cullen is a writer and author of the book "Columbine," about the 1999 school shooting in Littleton, Colorado. He was kind enough to join us from NPR's bureau in New York.